hospital moves and evacuations · using fmeca to improve patient safety during hospital moves and...
TRANSCRIPT
Using FMECA to improve patient safety during
hospital moves and evacuations
METHOD RESULTS
Laurence Schumacher, PharmD1, 2,*; Florian Berthaudin, MSc1, *; Anne-Laure Blanc, PharmD;
PhD2; Cédric Blatrie, PharmD 2; Anthony Staines, PhD3, 4; Pascal Bonnabry, PharmD, PhD1, 5;
Nicolas Widmer, PharmD, PhD1, 2
1 Center for Emergency and Disaster Pharmacy, Institute of Pharmaceutical Sciences of Western Switzerland, Geneva, Switzerland; 2
Pharmacy of Eastern Vaud Hospitals, Vevey, Switzerland; 3 Patient Safety Unit, Riviera–Chablais Hospital, Vevey, Switzerland; 4 IFROSS
Institute, University of Lyon 3, Lyon, France; 5 Pharmacy of Geneva University Hospitals, Geneva, Switzerland.
* These two authors contributed equally.
FIPSUB-1494
Contact : [email protected]
EVACUATION KIT
Checklist
- Medication
handling
- Transmission
- Tracking
Degraded Mode:
- Call-backs
- Field access to
patients
Known and
regularly
tested by staff
Patient algorithms:
- Triage
- Evacuation
Plans:
- Hospital
- SOP*
- Evacuation
*Standard Operating Procedures
This study highlighted the value of using
an FMECA of patient safety during
hospital moves and evacuations.
Moreover, preparing for a hospital move
could provide useful knowledge about
and an opportunity to test mitigation
actions to be included in hospital
evacuation procedures.
Risk Analysis Criticality Index (CI)
score CImax 810§
Failure Modes, Effects, and Criticality Analysis (FMECA) was carried out by a multidisciplinary team:
- Physicians - Logistics manager - Nurses - Manager - Pharmacists - Patient safety officer
* Pareto’s principle = 20% of failures with the highest Criticality Index scores were selected and analyzed in the 3rd session to determine improvements.
6 buildings, 400 beds, 2 wards: Internal Medicine
Unit (IMU) and Intensive Care Unit (ICU)
Team met three times (7 hours in total)
Move Evacuation
Failure modes 59 68
Analyzed 12 14
Averages initial
Criticality Index
scores
IMU 160 (105–294)
ICU 201 (125–343)
IMU 319 (245–504)
ICU 592 (441–810)
↓CI score after
mitigations
IMU 32 (-80%)
ICU 49 (-76%)
IMU 194 (-39%)
ICU 282 (-25%)
MOVE PROCESS
Medication
handling protocol
Depart
validation Departure
checklist
Pharmaceutical
support
Medical
checkpoint
§ Williams et al., Hospital pharmacy. 1994;29(4):331-2, 4-6, 9
Experiences of hospital moves are rare,
but they present similarities with
emergency situations such as hospital
evacuations. Failure Modes, Effects, and
Criticality Analysis (FMECA) was used to
anticipate the failure modes which might
affect patient safety during hospital
moves or evacuations.
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